title: Mental health self-assessment in patients with moderate to severe psoriasis: an observational, multicenter study of 1164 patients in Spain (the VACAP Study).
abstract: BACKGROUND
  Poor self-assessed mental health appears to be related to the severity of psoriasis.
  
  
  OBJECTIVE
  To evaluate the impact of psoriasis severity on mood and anxiety disorders.
  
  
  METHODS
  A prospective, observational, multicenter study was conducted by 123 dermatologists in Spain. Patients (n=164; mean [SD] age, 45.11 [13.92] years; 60.8% males) with moderate to severe psoriasis were evaluated at baseline and 4 months later. Psoriasis severity was measured using the Psoriasis Area and Severity Index (PASI), with a score range of 0 (mild) to 72 (severe); body surface area involvement (BSA); and physician global assessment (PGA) scores, with a range of 1 (mild) to 7 (severe). Mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with a total possible score of 0-42 (higher scores representing worse mental health). Mean first and second visit scores were compared.
  
  
  RESULTS
  Mean (SD) scores improved between the first and second visit as follows: 13.24 (9.50) to 5.07 (6.03) for PASI, 12.52 (7.92) to 10.78 (7.32) for overall HADS, 7.83 (4.55) to 6.85 (4.21) for the HADS anxiety subscale, and 4.72 (4.12) to 3.95 (3.76) for the HADS depression subscale (P<.001 in all cases). Multivariate analyses showed that the main factors related to anxiety were psoriasis severity, sex, and completion of graduate studies. The independent variables included in the model for depression were psoriasis severity, sex, and psoriasis located on the head.
  
  
  CONCLUSIONS
  Reductions in disease severity improve self-assessed mood and anxiety disorders in patients with moderate to severe psoriasis.
authors.affiliation: Hospital del Mar, Barcelona, Spain. Electronic address: rpujol@parcdesalutmar.cat.
authors.forename: R M
authors.initials: RM
authors.lastname: Pujol
authors.forename: L
authors.initials: L
authors.lastname: Puig
authors.forename: E
authors.initials: E
authors.lastname: Daudén
authors.forename: J L
authors.initials: JL
authors.lastname: Sánchez-Carazo
authors.forename: J
authors.initials: J
authors.lastname: Toribio
authors.forename: F
authors.initials: F
authors.lastname: Vanaclocha
authors.forename: M
authors.initials: M
authors.lastname: Yébenes
authors.forename: E
authors.initials: E
authors.lastname: Sabater
authors.forename: M A
authors.initials: MA
authors.lastname: Casado
authors.forename: M T
authors.initials: MT
authors.lastname: Caloto
authors.forename: B
authors.initials: B
authors.lastname: Aragón
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology* / Q000523:psychology*; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications* / Q000523:psychology*; D012720:Severity of Illness Index; D013030:Spain
keywords: Ansiedad; Anxiety; Depresión; Depression; Escala hospitalaria de ansiedad y depresión; HADS; Hospital Anxiety and Depression Scale; Psoriasis